THE DECIDUOUS

OR PRIMARY
TEETH
BY: DR. ROMMEL G. TOLEDO
Synonyms of deciduous teeth:

 Milk teeth
 Baby teeth
 Primary teeth
 Temporary teeth
 Juvenile teeth
 Lacteal teeth
 IMPORTANCE OR FUNCTIONS
OF DECIDUOUS DENTITION
• Cutting, shearing, and grinding and mastication of food
substances
• Maintenance of normal facial appearance
• Formulation of normal speech during development
• For the maintenance of space in the arch
• Directs path of eruption for the underlying permanent teeth
• To prevent spread of infection and inflammation to the underlying
permanent teeth
• For proper diet, in turn for general development of an individual (if
missing or badly decayed, the child will have food rejection habit)
DEVELOPMENT, CALCIFICATION AND
ERUPTIONS OF PRIMARY TEETH

• Definition of Eruption
• Eruption and Emergence
• Emergence of the primary dentition takes place between how
many months of postnatal life.
• It takes from how may years for the primary dentition to be
completed?
• Calcification of the primary teeth begins in utero from how
many weeks postfertilization?
• By how many weeks will all the primary teeth start to calcify?
 DECIDUOUS TEETH
• Teeth which function during childhood and then they are
shed and replace by permanent teeth.
• Decidiuous comes from a latin word “Decidere” meaning to
“fall off”
• There are 20 teeth in Decidiuous dentition. 10 maxillary and
10 mandibular.
• Beginning at the age of 6 years these teeth are gradually
replaced by the teeth of the permanent dentition.
ERUPTION OF THE DECIDUOUS TEETH
STARTS FROM 6MONTHS TO 2YEARS AND
ROOT COMPLETED AT THE AGE OF 3
MAXILLARY
CENTRAL
INCISORS
 LABIAL ASPECT

• Mesiodistal diameter of the crown is greater than

Cervicoincisal
• Labial surface is smooth
• No developmental line seen
• Root length is greater than crown length
• Root is conical with even tapered side.
 LINGUAL ASPECT

• Well developed marginal ridges and highly developed

cingulum.
• Cingulum extend up toward incisal ridge to divide lingual
surface in mesial, distal fossa.
• Root tapers lingually and present a ridge or its full length.
• Cross section of root is triangular.
 MESIAL AND DISTAL ASPECT

• Mesial and Distal aspect of central incisor are simillar.

• The curvature of cervical line is which represent the CEJ or
distinct curving toward incisal edge.
• Curvature distally is less than mesially.
• The crown appears thick at middle third.
 INCISAL ASPECT

• The incisal edge is relatively small.

• Labial surface appears broad
• Lingual surface taper towards cingulum
• Mesial and Distal surface are relatively broad
• Mesial and Distal surface taper towardss incisal.
 MAXILLARY
LATERAL INCISORS
 SIMILAR TO MAXILLARY
CENTRAL INCISORS

• Crown is smaller in all directions

• Cervico incisal length of lateral crown is greater than
mesiodistal.
• Distoincisal angles are more rounded.
• Root is much longer in proportion to its crown than central
incisors ratio.
MAXILLLARY
CANINE
 LABIAL ASPECT

• The crown is more constricted at cervix in relation to its

mesiodistal width.
• Mesiodistal surfaces are more convex
• Incisal edge form long well developed sharp cusp
• Cusp is longer and sharper than permanent teeth
• Mesial slope of cusp is longer than Distal slope of cusp
• Root is long, slender, tapering and more than twice in crown
length.
 LINGUAL ASPECT

• Cingulum, mesial and distal marginal ridge round

• Lingual ridge divide lingual surface in shallow mesiolingual
and distolingual fossa
• Root tapers lingually
 MESIAL ASPECT

• Outline form is similar to Central and Lateral incisors.

• The measurement labiolingually at cervical third is greater
 DISTAL ASPECT

• Simillar to mesial aspect except that curvature of cervical

line towards cusp ridge less than mesial.
 INCISAL ASPECT

• Crown is diamond shaped from this aspect.

• The tip of the crown is distal to center of crown.
• Mesial cusp slope is longer than distal cusp slope.
MAXILLARY FIRST
MOLARS
 BUCCAL ASPECT

• Widest measurement of crown of maxillary 1st molars is

at contact area mesially and distally.
• Crown converge towards cervix
• The occlusal line is slightly scalloped but with no definite
cusp form.
• Buccal surface is smooth with little evidence of
developmental grooves.
• Smaller than Maxilllary second molar
• Roots are slender and long
 LINGUAL ASPECTS

• The crown converge considerably in a lingual direction

making the lingual portion calibrate lesss mesiodistally than
buccal portion.
• Mesiolingual cusp is more prominent, longest and sharpest
cusp.
• Distolingual cusp is poorly defined.
• All 3 roots are seen
• Lingual root is larger than other.
 MESIAL ASPECT

• Dimension of cervical third is greater than dimension of occlusal third.

• A pronounced concavity is evident on buccal outline of cervical third.
• Cervical line mesially shows some curvature in direction of oclusal
surface
• A pronounced convexity is evident on the buccal outline of cervical
third
• Mesiobuccal and Lingual roots are visible only when looking at the
mesial side.
• Lingual root fron this aspect looks long and slender and extends
lingually.
 DISTAL ASPECT

• Crown is narrower distally than mesially.

• Tapers markedly towards distal end
• Distobuccal cusp is long and sharp
• Distolingual cusp is poorly developed
• Cervical line may curve occlusally
• All three roots are seen
• Point of bifurcation of disto buccal root and lingual root is
near CEJ.
 OCCLUSAL ASPECT

• The calibration of distance between mesiobuccal line and

distobuccal line angles is greater than mesiolingual and
distolingual.
• The occclusal surface has central fossa, mesial triangular
fossa just inside mesial marginal ridge.
• Buccal developmental grooves divides mesiobuccal and
distobuccal occlusally.
• Oblique ridge is found connecting the mesiolingual and
distobuccal cusp.
• Distal marginal ridge is poorly defined.
MAXILLARY 2ND
MOLAR
 BUCCAL ASPECT

• Resembles permanent maxillary 1st molars but is smaller.

• Two well defined buccal cusp and buccal groove is seen.
• Crown is longer thank 1st molars
• Crown is narrow at cervix
• Roots appears slender from this aspect
 LINGUAL ASPECT

• Crown shows three cusp:

1. Mesiolingual
2. Distolingual
3. Supplemental (tubercle of carabelli)

• A well defined developmental groove separates the

mesiolingual cusp from distolingual cusp.
• All the 3 roots are visible, lingual root is largest.
 MESIAL ASPECT

• Crown appears short because of its width buccolingually in

comparison with its length.
• Mesiolingual cusp with its supplementary 5th cusp appears
large in comparison with mesiobuccal cusp.
• Mesiobuccal root from this aspect is broad and flat.
• Lingual root has somewhat same curvature as rhe lingual
root of first molar.
 DISTAL ASPECT

• Distal calibration of the crown is less than mesial.

• Distobuccal and Distolingual cusp are about the same in
length.
• The cervical line is approximately straight.
• All three roots are seen
• Distobuccal root are shorter and narrower than others.
• The point of bifurcation between distobuccal root and lingual
root is more apical in location.
 OCCLUSAL ASPECT

• Rhomboidal in shape
• Well developed cusp and supplemental cusp is found
• Buccal surface is flat
 THE OCCLUSAL SURFACE
CONSIST OF
1. Central fossa
2. Mesial Triangular fossa
3. Central groove
4. Oblique ridge
5. Distal developmental groove
6. Distal triangular fossa
7. Lingual developmental groove
8. Distal marginal ridge
9. Mesial marginal ridge
10. Central pit
MANDIBULAR
CENTRAL
INCISORS
 LABIAL INCISORS

• Flat face with no developmental groove

• Mesial and Distal side of the crown are tapered evenly from
contact area.
• Crown is wide in proportion to its length in comparison with
that of its permanent successor.
• The root of primary Central incisor is long, evenly tapered
down to the apex.
 LINGUAL ASPECT

• Marginal ridge and cingulum may be located easily.

• Lingual surface of crown at middle third and incisal third
may have a flattened surface or may present with slightly
concavity.
• Lingual portion of crown and root converge so that it is more
narrow towards the lingual.
 MESIAL ASPECT

• Convexity of cervical contours at cervical third is

pronounced.
• Labiolingual measurement of teeth is only a mm less than
primary maxillary central incisors.
• Mesial surface of root is nearly flat and evenly tapered.
 DISTAL ASPECT

• Outline of teeth from the distal aspect is reverse from mesial

aspect.
• Cervical line of crown is less curved towards incisal ridge
than on mesial aspect.
• Developmental depression is present on root
 INCISAL ASPECT

• Incisal ridge is straight and bisect the crown labiolingually.

• A definite taper is evident towards the cingulum on lingual
side.
• Labial surface term this view presents a flat surface slightly
convex, whereas the lingual surface present a flattened
surface slightly concave
 MANDIBULAR
LATERAL INCISORS
 MANDUBULAR LATERAL
INCISORS
• Somewhat larger in all measurement than central incisor.
• Cingulum is little more generous than that of central incisor
• Lingual surface of crown is more concave
• Incisal ridge slope downward distally.
MANDIBULAR
CANINE
 MANDIBULAR CANINE

• Crown is 0.5mm and root is 2mm shorter than maxillary

canine.
• Mesiodistal measurement of mandibular canine is less when
its compared to its mesiodistal measurement contact area
than maxillary canine.
• The cervical ridge labially and lingully are not quite as
pronounced as those in maxillary canine.
MANDIBULAR 1ST
MOLAR
 BUCCAL ASPECT

• Mesial outline of crown is straight constricting the crown at cervix.

• Distal portion of crown is shorter than the mesial portion and convex in
outline
• Cervical deeper and towards the mesial
• Cervical ridge is quite prominent especially in the mesial portion and
this cervical bulge is also known as “Tubercle of Zuckerkandl”.
• Two buccal cusp are distinct
• No developmental groove
• Mesiobuccal cusp is larger than distobuccal cusp
• Roots are long and slender and wide buccolingually with mesial root
longer and wider
 LINGUAL ASPECT

• Crown, root converge lingually to marked degree

• Distolingual cusp is rounded
• Mesiolingual cusp is long and sharp
• Mesial marginal ridge is well developed
• Cervical line is straight
 MESIAL ASPECT

• The most noticeable thing from mesial aspect is extreme

curvature buccally at cervical third.
• Both the mesiobuccal and mesiolingual cusp are seen
with a well developed marginal ridge.
• Cervical line slants upwards buccolingually
• Root end is flat and square
• Development depression is present
• Buccal and Lingual outline of root drop straight down to
crown.
 DISTAL ASPECT

• Cervical line doesn’t drop bucally

• Length of crown buccally and lingually more uniform
• Distobuccal and distolingual cusp are not as sharp as mesial
• Distal marginal ridge is not well defined
• Distal root is rounded and shorter
 OCCLUSAL ASPECT

• Rhomboidal in shape
• Mesuolingual cusp may be seen as largest and well
developed
• Buccal and central developmental groove are found.
• Other landmarks are:
1. Central developmental groove
2. Lingual developmental groove
3. Distal marginal ridge
4. Distal triangular fossa
MANDIBULAR 2ND
MOLAR
 BUCCAL ASPECT

• Narrow mesiodistal calibration at the cervical portion of the

crown with compaired with mesiodistally on crown at contact
level.
• Mesiobuccal and distobuccal developmental grooves divide
the surface in their cusp.
• Roots are slender and long
• Have characteristics flare mesially
• Point of bifurcation is found below CEJ.
 LINGUAL ASPECT

• Two lingual cusps of almost equal dimmension are seen.

• A short lingual groove is present
• Cervical line is straight
• Mesial portion of crown is seems to be little higher
• A portion of each of there buccal cusp may be seen.
 MESIAL ASPECT

• Crest of contours bucally is more prominent

• Marginal ridge is high
• Lingual cusp is longer and higher
• The mesial root is broad and flat with a blunt apex.
 DISTAL ASPECT

• Crown is not as wide as medially.

• Distolingual cusp is well developed
• Cervical line is regular
• Distal root is almost as mesial and flattened on distal
surface.
• Distal root taper more at apical
 OCCLUSAL ASPECT

• Three buccal and two lingual cusp are equally matched.

• Well defined triangular ridge found
• Other landmarks are central groove, Mesial and distal
groove.
LIST OF DIFFERENCES BETWEEN
DECIDUOUS AND PERMANENT
DENTITION
SI. No. Features Deciduous Permanent

General Features

1. Total Number 20, 5 in each quadrant 32, 8 in each

quadrant

2. Premolars Absent Present

3. Molars Only 2 3 in Number

4. Posteriors – largest Second molars First molar

5. Duration Short period Lifelong

6. Beginning of eruption At six months Six years

7. Complete set of teeth 2 ½ to 3 years 18 to 21 years old

8. Presence in oral cavity 6 months to 13 years 6 years onward

(lifelong)

9. Crown size Smaller in all dimensions Larger in all

dimensions

10. Width and height Mesiodistal is more than Cervico-occlusal is

cervico-occlusal (short) more than
mesiodistal except
molars (long)
SI. No. Features Deciduous Permanent
Morphological features
11. Color Milky white to bluish Yellowish white to
grayish
12. Cervical ridge More prominent on buccal Flatter, occasionally
aspect of all teeth pronounced in molars
13. Occlusal table Narrow Wide
14. Developmental grooves Few and less prominent More and are
and depressions prominent
15. Cervix More constricted Less constricted
16. Contact area Small Broad
17. Molar appearances Bulbous and sharply Wider and less
constricted at cervix constricted
18. Occlusal plane Flat (cusps and grooves More curved
are less prominent) (prominent cusps and
grooves)
19. Supplemental grooves More Less
20. Roots Longer and slender Shorter and bulkier
SI. No. Features Deciduous Permanent
Morphological features
21. Furcation Close to the cervix More apical
22. Root trunk Smaller Larger
23. Root-MD dimension Narrow Wider
24. Molar roots-flaring More (contain permanent Less or no flaring
tooth buds) (within the boundaries
of the crown)
25. Crown root ratio Less (roots are longer than More (relatively less of
crown) about 1:1.5)
26. Root resorption Present and is Absent and if seen,
physiological pathological
27. Exfoliation Present and physiological Absent and
pathological
28. Internal anatomy Closely resembles external Less resembles,
anatomy especially in pulp
chamber anatomy
29. Pulp chamber-size Large Small
30. Pulp horns Prominent, higher and Less prominent,
close to surface placed lower and more
apical
SI. No. Features Deciduous Permanent
Morphological features
31. Mammelons Not present Common in newly
erupted
32. Canines Slender and cornical Long and bulbous
33. Roots in anterior Labially tilted Distally tilted
34. Anatomical variations Less Common
35. Structural variations Absent or very minimal Common e.g.
fluorosis, Turner’s
hypoplasia
36. Enamel-thickness Thinner and uniform of Thicker and varies,
about 2mm ranges from
featheredge to 2.5mm
37. Enamel-rods Slopes occlusally Slopes gingivally
(cervically)
38. Pulp-wall and floor Thicker, and porous Less thicker not
porous
39. Pulp-cellularity and High Less
vascularity
40. Repair High chances and faster Less and if slow
SI. No. Features Deciduous Permanent
Morphological features
41. Root canals Thin, curved and branched Well-defined, less
branched
42. Apical foramen Large Constricted
43. Nerve endings in pulp Cell free zone and Extend beyond the
odontoblastic area odontoblastic area
into the predentin
44. Nerve innervations Less More
45. Mineralization Less High
46. Neonatal lines Present, in all teeth (teeth Absent, seen only in
develop before birth) first molars
47. Dentinal tubules Less regular More regular
48. Total dentin thickness Half that of permanent Double that of primary
49 Interglobar dentin Absent Present below the
mantle dentin
50. Dentino enamel junction Less prominent and linear More prominent and
scalloped
SI. No. Features Deciduous Permanent
Morphological features
51. Cementum Thin and mainly primary Thich and secondary

52. Pulp-infection and Poorly localized Well-demarcated

inflammation
53. Periodontal problems Less Common
54. Age changes Less (present for short More (lifelong)
duration)
SI. No. Features Deciduous Permanent
Clinical procedures
55. Cavity Size Small Large
56. Cavity depth Shallow Deep
57. Cavity width Narrow Broad
58. Cavity walls Less converging occlusally More converging
occlusally
59. Proximal walls More converging Less converging
occlusally occlusally
60. Bevel Not given Given at gingival seat
61. Pulpotomy-molars Involvement of furcation Involvement of
more (thin pulpal floor) furcation less
62. Pulpectomy-molars Difficult (thin, curved and Relatively easy (Well-
irregular canals) tilted. Extract
carefully)
63. Roots-anterior Conical, facilitate easy Long, conical and
removal distally tilted. Extract
carefully
SI. No. Features Deciduous Permanent
Clinical procedures
64. Roots-posterior Roots divergent extract Roots fused or distally
carefully, premolar buds tilted
located between roots
THE END 